A STUDY ON CLINICAL, LABORATORY MANIFESTATION AND EFFECT ON MAJOR ORGAN SYSTEM IN HYPOTHYROIDISM IN TERTIARY CARE HOSPITAL OF SURAT CITY

Background: In addition to common classic manifestation of hypothyroidism, there are many additional manifestation of hypothyroidism that is less commonly acknowledged. The present study was planned with an objective to study the clinical profile, biochemical abnormalities and effect on major organ system of hypothyroidism. Methodology: All the patients were examined & symptoms and sign of hypothyroidism noted and then subjected to investigation, which includes routine investigation (RBS, S.Creatinine, CBC, ESR, Urine Analysis, Chest X-ray, ECG, S.cholesterol, S. protein. Specific investigation like echocardiography is also advised accordingly. Results: Facial puffiness in present in 24 (48%), Pedal edema in 20 (40%) and dyspnea and chest discomfort was present in 30% of patient. Among the neurological manifestations, delayed nerve jerk was present in 8 (16%), Hoarseness Of voice in 15 (30%) and deafness and impairment of memory was present in 2% of patient. Sinus bradycardia was present in 2 cases. Low voltage ECG in 5(10%).Low voltage with T wave changes observed in 4 cases.ST-T changes in 5 patients. Left ventricular hypertrophy presents in 4 cases. Conclusion: ST-T changes in the form of flat or inverted T wave was the most common abnormality in electrocardiogram i.e.14%, Sinus bradycardia was present in 4% of cases. Menorrhagia was the most common menstrual problem observed in 20% of cases, Anemia (Hb <11gm %) in 40 (80%), Serum cholesterol level was more than 200 mg % in 26(52%) cases

EFFECT OF METFORMIN ON HEART RATE VARIABILITY IN NEWLY DIAGNOSED TYPE 2 DIABETES MELLITUS PATIENTS AT A TERTIARY CARE HOSPITAL

OBJECTIVES – There is a worldwide epidemic of Type 2 diabetes mellitus (T2DM). It is associated with cardiovascular autonomic neuropathy. Heart rate variability (HRV) is the gold standard for its measurement. Thus, effect of metformin therapy on HRV was evaluated in newly diagnosed T2DM patients. METHODS – This was a prospective, observational study carried out from January 2020 to September 2021 in the medicine outpatient department of a tertiary care hospital in Gujarat, India. The study included newly diagnosed T2DM patients of both genders aged 18-70 years. Baseline HRV parameters were recorded by performing electrocardiogram for a fixed duration of 5 minutes. Follow up was done after 6 months of metformin 500 mg monotherapy. Time domain analysis was done using square root of mean square of successive R-R interval difference (RMSSD) and frequency domain analysis was done using low frequency/high frequency (LF/HF) ratio. Paired t-test was used for analysis. P&lt;0.05 was considered statistically significant. RESULTS – A total of 30 patients were included in the study. The mean age of the patients was 43.5 ± 4.5 years. The highest number of patients were from age group between 41-50 years (33.3%). There were more number of females (56.7%) compared to males (43.3%). There was an increase in the RMSSD value after metformin treatment, but it was not statistically significant (P= 0.308). In frequency domain analysis, there was no significant improvement in LF, HF as well as LF/HF ratio (P = 0.655). &nbsp; CONCLUSION – There was a minor improvement in HRV parameters after six months of metformin therapy, but it was not statistically significant. Further studies with larger sample size should be planned with one or more oral hypoglycaemics